Yin Zhang1, Mingyang Song1,2,3,4, Andrew T Chan2,3,5, Jeffrey A Meyerhardt6, Walter C Willett1,4, Edward L Giovannucci7,8. 1. Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA. 2. Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA. 3. Clinical and Translational Epidemiology Unit and Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA. 4. Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA. 5. Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA, USA. 6. Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA. 7. Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA. egiovann@hsph.harvard.edu. 8. Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA. egiovann@hsph.harvard.edu.
Abstract
BACKGROUND: Hypertension and the use of antihypertensive medications have been intensively investigated in relation to colorectal cancer (CRC). Prior epidemiologic studies have not been able to examine this topic with adequate confounding control and follow-up time, or disentangle the effects of antihypertensive agents and hypertension. METHODS: Eligible participants in the Nurses' Health Study and Health Professionals Follow-up Study were followed for up to 28 years, with repeat assessments of exposures. Cox proportional hazards models were used to estimate hazard ratios and 95% confidence intervals. RESULTS: In fully adjusted analyses based on both new-user and prevalent-user designs, there was no association between the use of beta-blockers, calcium-channel blockers, thiazide diuretics, angiotensin-converting enzyme inhibitors, furosemide, other antihypertensive drugs and CRC risk and mortality reached the statistically significant threshold after Bonferroni correction. The results remained similar in sensitivity analyses among participants with hypertension. Before Bonferroni correction, suggestive associations between beta-blocker use and CRC risk and between furosemide use and CRC-specific mortality were observed specifically in analyses using a new-user design. Hypertension was not associated with CRC risk in analyses based on both new-user and prevalent-user designs. CONCLUSIONS: Hypertension and long-term use of major classes of antihypertensive medications are unlikely to be associated with CRC risk and mortality.
BACKGROUND: Hypertension and the use of antihypertensive medications have been intensively investigated in relation to colorectal cancer (CRC). Prior epidemiologic studies have not been able to examine this topic with adequate confounding control and follow-up time, or disentangle the effects of antihypertensive agents and hypertension. METHODS: Eligible participants in the Nurses' Health Study and Health Professionals Follow-up Study were followed for up to 28 years, with repeat assessments of exposures. Cox proportional hazards models were used to estimate hazard ratios and 95% confidence intervals. RESULTS: In fully adjusted analyses based on both new-user and prevalent-user designs, there was no association between the use of beta-blockers, calcium-channel blockers, thiazide diuretics, angiotensin-converting enzyme inhibitors, furosemide, other antihypertensive drugs and CRC risk and mortality reached the statistically significant threshold after Bonferroni correction. The results remained similar in sensitivity analyses among participants with hypertension. Before Bonferroni correction, suggestive associations between beta-blocker use and CRC risk and between furosemide use and CRC-specific mortality were observed specifically in analyses using a new-user design. Hypertension was not associated with CRC risk in analyses based on both new-user and prevalent-user designs. CONCLUSIONS: Hypertension and long-term use of major classes of antihypertensive medications are unlikely to be associated with CRC risk and mortality.
Authors: Sripal Bangalore; Sunil Kumar; Sverre E Kjeldsen; Harikrishna Makani; Ehud Grossman; Jørn Wetterslev; Ajay K Gupta; Peter S Sever; Christian Gluud; Franz H Messerli Journal: Lancet Oncol Date: 2010-11-29 Impact factor: 41.316
Authors: A F Lever; D J Hole; C R Gillis; I R McCallum; G T McInnes; P L MacKinnon; P A Meredith; L S Murray; J L Reid; J W Robertson Journal: Lancet Date: 1998-07-18 Impact factor: 79.321
Authors: K B Michels; B A Rosner; A M Walker; M J Stampfer; J E Manson; G A Colditz; C H Hennekens; W C Willett Journal: Cancer Date: 1998-11-01 Impact factor: 6.860